Could HHSC Face a Public Ed-Sized Leadership Void?

Everyone’s talking about the instability of public education policy in Texas, between sweeping budget cuts and the impending departures of three top school finance wonks from the Legislature — Reps. Rob Eissler and Scott Hochberg, and Sen. Florence Shapiro — and Commissioner Robert Scott from the Texas Education Agency.

Now health and human services may be giving public ed a run for its money.

First, the state’s Medicaid director, Billy Millwee, announced he was retiring after two decades with the Health and Human Services Commission. Now an agency spokeswoman says HHSC chief Tom Suehs hasn’t decided whether or not to retire in August, leaving the possibility that there could be a gaping hole this summer at the top of an agency facing billions of dollars in unpaid Medicaid costs and struggling to institute a federal waiver that calls for complex hospital payment reform.

If he's considering retiring, Suehs couldn’t be blamed for it. He’s got doctors screaming about Medicaid and Medicare cuts on one side. On the other, public and private hospitals are duking it out over who wins and who loses from a complicated new formula to determine how much they’re reimbursed for uncompensated care. Meanwhile, counties and hospital districts are facing their own mini turf wars, as they work to form the regional partnerships required by the waiver.

If Suehs leaves in addition to TEA's Scott, the double agency challenge presents an opportunity of sorts for Gov. Rick Perry, who's coming off of a losing presidential bid and batting away suggestions that he could be a lame duck governor. With the possibility of a big leadership void, he could reassert his authority over education and health and human services, which (if you include higher education) make up nearly 85 percent of the state's general revenue budget.

TMA Targets Women's Health

Talk about not toeing the line: the Texas Medical Association, which represents many of the state’s doctors, has finalized its legislative agenda for the 2013 session — and women’s health is at the top of the list.

The group knows that with an overwhelmingly conservative Legislature it won’t have much luck repealing abortion sonograms, a state mandate the TMA dislikes because many doctors believe it infringes on their relationship with patients.

But TMA’s members are taking a targeted approach: They’ll be advocating for the restoration of the tens of millions of dollars in annual family planning funding lawmakers stripped out last session, part of an effort to defund Planned Parenthood while meeting the state’s budget shortfall.

They’re also going to aggressively try to revise the state’s mandatory “Women’s Right to Know” policy, which requires doctors to give women seeking abortions a brochure that dedicates nine pages to the risks of abortion, including feeling “guilty, sad or empty,” having “suicidal thoughts,” and being at higher risk for breast cancer. The TMA says much of the pamphlet is pure fiction (the American Psychological Association, for example, says women who have elective first-trimester abortions have no greater risk of mental health problems; the National Cancer Institute says large studies have shown no link between abortion and breast cancer).

A TMA letter published on the group’s website in May calls for a “more rigorous approach to reviewing these materials to help ensure that language is rooted in science and evidence-based clinical literature.”